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Depression and cerebrovascular disease.

R G Robinson1, P L Morris, J P Fedoroff

  • 1Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Md. 21205.

The Journal of Clinical Psychiatry
|July 1, 1990
PubMed
Summary

Poststroke depression is common but treatable. Tricyclic antidepressants effectively manage depression and may improve recovery after stroke.

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Area of Science:

  • Neurology
  • Psychiatry
  • Clinical Medicine

Background:

  • Depressive disorder frequently complicates stroke recovery.
  • Somatic symptoms post-stroke can mimic depression, necessitating clear diagnostic criteria.
  • Understanding the causes of poststroke depression is crucial for effective management.

Purpose of the Study:

  • To evaluate the appropriateness of DSM-III criteria for diagnosing major depression in stroke patients.
  • To explore the etiological factors contributing to poststroke depression.
  • To assess the efficacy of tricyclic antidepressants in treating poststroke depression and their impact on recovery.

Main Methods:

  • Review of clinical evidence and diagnostic criteria (DSM-III).
  • Analysis of lesion characteristics in relation to depression.
  • Consideration of psychosocial factors like social support and gender.
  • Evaluation of treatment outcomes with tricyclic antidepressants.

Main Results:

  • DSM-III criteria are suitable for diagnosing major depression post-stroke.
  • Both neurological (lesion characteristics) and psychosocial factors (social support, gender) influence poststroke depression.
  • Tricyclic antidepressants are effective in treating poststroke depression.
  • Treatment with these antidepressants may also improve physical and cognitive functions.

Conclusions:

  • Poststroke depression is a significant clinical issue with multifactorial causes.
  • A disease model is applicable to some cases of poststroke depression.
  • Psychosocial factors play a role in its occurrence.
  • Pharmacological treatment with tricyclic antidepressants offers a viable therapeutic option and potential recovery benefits.

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